Browsing Tag: Arthritis Medications

Brushing and Flossing Prevents RA


One simple task you can do to prevent rheumatoid arthritis

Brush And Floss To Prevent Rheumatoid Arthritis

Ruth Kava writing for the American council on Science and  Health reported recent research published in Science Translational Medicine suggests how good dental care might well be an important factor in preventing the onset of RA.

The investigators, led by Dr. Maximilian Koenig from the Johns Hopkins University School of Medicine, explained that a bacterium associated with periodontal disease — Aggregatibacter actinomycetemcomitans (Aa) — could be the initiator of the autoimmune feature of RA. The investigators noted that Aa, of all the other identified microbes, was the only one known that could produce the spectrum of antigens found in the joints of individuals with RA.

To investigate this possibility, they collected fluid from the gum regions of people with periodontal disease and from those of controls and analyzed them for the presence of altered proteins which are known to be immune system targets.  In sum, people with periodontitis are more likely to have the Aa bacterial toxin and thus more likely to produce targets for the immune system. This in turn, links periodontal disease and rheumatoid arthritis.

Comment: An interesting finding that confirms the research of others.

Silk Delivery for Arthritis


Tired of taking bunches of pills for arthritis?  Here’s an alternative… next

Better than a pill: Team to develop new arthritis treatment via silk

Erika Ebsworth-Goold writing in Medical Xpress reported a team of researchers from Washington University in St. Louis will use silk micro-particles to deliver long-lasting therapeutic compounds, helping better alleviate the pain of inflammation and injury.

“We’re starting to see that many areas can’t be reached via oral drug delivery,” said Lori Setton, the Lucy & Stanley Lopata Distinguished Professor of Biomedical Engineering at the School of Engineering & Applied Science.

Setton, said an intracellular compound called nuclear factor kappa B (NF-kB) is a main culprit in cellular breakdown, inflammation and pain after an injury. She’s working in the lab on a new solution using silk to deliver two specific molecules that can inhibit NF-kB at the site of a fracture or injury in an effort to stave off long-term joint damage.

“Silk naturally doesn’t interact with water, and, when you mix it with these molecules that also don’t interact with water, they bind to each other very strongly,” Setton said. “We believe these selective compounds are therapeutically effective, but we’ve never been able to get them to their target site. By delivering them with the silk, we hope to get large doses to the target site with low toxicity and to have them remain in that compartment for longer periods of time.”

Silk is an attractive delivery vehicle because of its long history of safe clinical use

According to Setton, the enhanced drug-delivery system has the potential to prevent the onset and progression of joint damage in patients suffering from acute injuries, like minor joint fractures, ligament or meniscal tears.

“Patients with joint trauma tend to go on to develop osteoarthritis at a higher rate compared to someone who doesn’t have the injury,” Setton said. “It’s a whole different type of arthritis development that we don’t know a whole lot about, but we believe we can intervene early with new drug delivery and treatments, and prevent onset at a later stage.”

Comment: Nice concept

Reduced Risk of Death in Weekend Warriors


Hey… are you a weekend warrior?   Here’s some good news for you…

Do Exercise ‘Weekend Warriors’ Lower Their Risk Of Death?

Dr. Jack cush writing in RheumNow reported a new article published in JAMA Internal Medicine suggests that compared with inactive adults, weekend warriors who performed the recommended amount of 150 minutes of moderate or 75 minutes of vigorous activity in one or two sessions per week had lower risks for death from all causes, cardiovascular disease (CVD) and cancer.

Although it may be easier to fit less frequent bouts of activity into a busy lifestyle, little has been known about the weekend warrior physical activity pattern.

Gary O’Donovan, Ph.D., of Loughborough University, England, and coauthors conducted a pooled analysis of 63,591 adults who responded to English and Scottish household-based surveys. Data were collected from 1994 to 2012. The authors looked at associations between the weekend warrior and other physical activity patterns and the risk for death from all causes, CVD and cancer.

The risk of death from all causes was about 30 percent lower among weekend warrior adults compared with inactive adults, while the risk of CVD death for weekend warriors was 40 percent lower and the risk of cancer death was 18 percent lower.

Comment: Wow.  Unexpected good news.

Effectiveness of PRP for OA of the Knee


Which works better for osteoarthritis of the knee?  Find out next…

Efficacy Of Platelet-Rich Plasma In The Treatment Of Knee Osteoarthritis: A Meta-Analysis Of Randomized Controlled Trials.

Dr. Jack Cush writing in Rheumnow reported on a large study evaluating the use of platelet rich plasma (PRP) vs other therapies. The analysis showed that at 6 months postinjection, PRP and hyaluronic acid (HA) had similar effects with respect to pain relief.   At 12 months postinjection, however, PRP was associated with significantly better pain relief than HA. The researchers also noted that PRP did not increase the risk of adverse events compared with HA and saline.

Current evidence indicates that, compared with HA, intra-articular PRP injection may have more benefit in pain relief and functional improvement in patients with symptomatic knee OA at 1 year postinjection.

Comment: PRP is definitely an effective treatment modality for OIA of the knee. It must be administered via US though for best results.

PPI Dangers

https://youtu.be/gZnad4HcbRc
PPI Safety Issues

Dr. Jack Cush writing in Rheum Now reviewed the safety of proton pump inhibitors, drugs that have been used for peptic ulcer disease, as well as reflux.

Among the safety concerns are…

PPIs will decrease gastric acid and may affect drug blood levels where absorption is acid dependent, including several antiretroviral and cancer therapy drugs. Other drugs, such as digoxin, may be absorbed more extensively when gastric acid is reduced; thus, digoxin toxicity may occur with PPI use. Warfarin’s effect also is increased in patients taking PPIs. Decreased gastric acid can lower absorption of vitamin B12, calcium, iron, and magnesium.

An analysis of 9 studies found a 40% increased risk of low magnesium with PPI. If severe, hypomagnesemia may lead to muscle weakness, tetany, convulsions, arrhythmias.

Due to the lowering of gastric acidity, there is a higher risk of Clostridium difficile infection and community-acquired pneumonia among PPI users.

Recent large reviews show that there is a 50% increased risk of chronic kidney disease and an increased risk of acute kidney disease with chronic PPI use.

PPIs may decrease bone density and increase fracture risk by reducing intestinal calcium absorption.

Given these impactful risks, clinicians should try to use the lowest possible dose of PPI and to discontinue PPI therapy if it is not essential. The benefits of PPI therapy must be weighed against their potential contribution to harm in susceptible individuals. Some patients may benefit from intermittent or on-demand regimens may be sufficient to manage problems or control symptoms.

Comment: Food for thought.

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